Sam Bauman: When it’s time to brown bag all your meds
As we age our bodies change, often requiring medications. Seniors may well use five or more meds regularly, often prescribed by different doctors. I’m an example, but most of my drugs are prescribed by Veterans Affairs doctors who share computer data on me. So my four prescriptions — two for blood pressure, one for blood thinner and one for B-12 vitamins plus an eye vitamin — are checked to make sure they don’t cause problems.
For most of us, particularly seniors, our meds may not work well together. One way to find out is to “brown bag” all of our meds and supplements and take the bag to our doctor or pharmacist for a check of effectiveness, duplications or bad reactions.
In fact, taking five or more meds and supplements as many Americans do can do more harm than good if you’re not carefully monitored.
“The chances of drug interaction or side effects increase dramatically as the number of medications you take go up,” says Dr. Michael Steinman of the University of California.
Sometimes these interactions magnify a drug’s potency, sometimes they diminish it, sometimes they my trigger dangerous side effects.
“And, they’re becoming much more common,” says pharmacist Dina M. Oato. “Two-thirds of older adults take five or more meds and supplements daily, up 14 percent since 2006. And one in six use meds and supplements that shouldn’t be combined,” she said.
According to Consumer Reports “On Health” here’s how to stay safe when taking multi medications. Do the brown bag check up with your druggist or doctor yearly. Include everything, including OTC items. During the review the doctor or druggist should check for interactions or whether you’re taking different drugs for the same problem so you can drop one, and ask if the dose can be lowered.
After your brown bag review, make a list of all the meds and supplements you take including reason for taking the drug, dosage and doctor who prescribed it. Give the list to every doctor or druggist you see and review it every time you add or subtract something. Get all your prescriptions filled at the same drug chain as they usually share info and can easily spot problems.
You can avoid problems if you ask what the new one is for. Or how long you should take it. This can head off longer use when not needed. “Is this new one similar to one I’m already taking?” And sleep aids should only be taken for short periods because they can be habit forming. Exiting a hospital usually results in being given drugs that you will not need at home, such as laxatives, pain relievers and sleeping aids you will not need.
Always ask if non-drug alternatives can be used. Lifestyle changes such as losing weight and exercising can reduce the need for meds.
Some drug combinations to avoid:
Warfarin with Amiodarone and certain pain relievers such as anisole, aspirin, ibuprofen (Advil) and naproxen (Aleve), bleeding risk.
Theophylline with Cimetidine, seizure risk.
Lithium with loop diuretics and ACE inhibitors.
Prednisone with some pain relievers such as Advil and Aleve.
If you and your doctor decide that you should drop a drug, use these tips:
Make a plan to schedule tapering off a drug with follow-up appointments with your doctor.
Get list of warning signs and call your doctor if they emerge.
Keep symptoms from returning by exercise and psychotherapy which can ward off depression.
For more information, check CRbestbuydrugs.org.
Lifestyle notes from HEART PLUS:
Walking 2 miles a day reduces heart disease by 45 percent (JAMA)
Eating three or more fruits and vegetables results in 15 percent less of overall death (NHANES)
Eat fish such as flounder, sole, halibut, herring, mackerel, rainbow trout, salmon, or sardines, all rich in omega-3 fatty acids. Benefits are 31 percent reduction in heart disease, heart attack and death (JAMA), and reduction in sudden death (NEJM).
Less than 7 percent of daily calories should come from saturated fats. For a typical 2,000 calorie diet this should be less than 15 grams per day. Saturated fats such as red meat , 3 oz. = 4-7 grams, cup of whole milk 8 grams, teaspoon butter 7.2 grams, teaspoon palm oil, 6.7 grams, coconut oil teaspoon 11.8 grams, donut 5 grams and snack foods — read the labels.
Studies show that the human body can only metabolize about 300 calories an hour. Keep meals at about 700 calories or less. Smaller, more frequent meals are more easily metabolized.
Sam Bauman writes about senior affairs, among other things, for the Nevada Appeal.